Evidence map›Paper›PMID 40389892›Full record

SynthesisBMC nephrology2025

Burden of corticosteroid therapy in patients with immunoglobulin A nephropathy (IgAN): a systematic literature review.

Sarah N Ali, Nicole Fusco, Dilip Makhija, Vakaramoko Diaby, Tosin Oladapo, Darsh Devani, Cibele Pinto, Mohit Mathur, Ancilla W Fernandes

Abstract readSystematic Review
In one paragraph

Synthesis in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sarah N AliOtsuka Pharmaceutical Development and Commercialization, 508 Carnegie Center, Princeton, NJ, 08540, USA. Sarah.Ali@otsuka-us.com.
Nicole FuscoCencora, Conshohocken, PA, USA.
Dilip MakhijaOtsuka Pharmaceutical Development and Commercialization, 508 Carnegie Center, Princeton, NJ, 08540, USA.
Vakaramoko DiabyOtsuka Pharmaceutical Development and Commercialization, 508 Carnegie Center, Princeton, NJ, 08540, USA.
Tosin OladapoCencora, London, UK.
Darsh DevaniCencora, Conshohocken, PA, USA.
Cibele PintoOtsuka Pharmaceutical Development and Commercialization, 508 Carnegie Center, Princeton, NJ, 08540, USA.
Mohit MathurVisterra, Inc, Waltham, MA, USA.
Ancilla W FernandesOtsuka Pharmaceutical Development and Commercialization, 508 Carnegie Center, Princeton, NJ, 08540, USA.

Funding

Otsuka Pharmaceutical Development and Commercialization Not applicable
6 · The paper itself

Abstract

backgroundImmunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis (GN) worldwide. While specific treatment differs regionally, treatment usually focuses on background therapy, with short-term (≤ 6 months) corticosteroids recommended as an add-on treatment for patients at high risk of progressive chronic kidney disease. Although corticosteroids can help to manage IgAN, treatment with corticosteroids may lead to undesirable adverse outcomes.

objectiveTo highlight corticosteroid treatment burden in patients with IgAN globally.

methodsEmbase, MEDLINE, and Cochrane CENTRAL were searched for articles published in any language from January 1, 2013 to August 24, 2023. Eligible studies reported ≥ 1 outcome related to the clinical, humanistic, or economic burden of corticosteroids in patients with IgAN. Articles were independently screened by 2 reviewers. Data extraction and quality assessment were completed by 1 researcher and validated by a second. Results are reported among the number of studies with data on each outcome.

resultsOf 1,024 records screened, 64 studies were included. Of 37 studies reporting treatment duration, 68% found that corticosteroids were used long-term (range: 8-24 months). In studies reporting data for long-term use (> 6 months), there were more overall AEs and serious AEs with corticosteroids than with comparator treatments (e.g., background therapy alone, tonsillectomy, placebo). Rates of metabolic AEs, Cushing's syndrome, edema and sleep disorders were also higher with long-term corticosteroids than with comparator treatments; however, most studies did not report the statistical significance of these results. Infection rates were similar between corticosteroids and comparator treatments.

conclusionsCurrent guidelines recommend short-term corticosteroid treatment for patients at high risk of progression but long-term use appears to be widespread. Corticosteroids may lead to adverse outcomes and should therefore be reserved only for IgAN patients most at risk of rapid progression to end-stage kidney disease and for limited duration. Novel corticosteroid-sparing therapies are necessary to supplement the current treatment landscape.

Indexed as

Adrenal Cortex HormonesGlomerulonephritis, IGAHumansAdrenal Cortex HormonesCorticosteroidsImmunoglobulin A nephropathySafetyTreatment burdenTreatment patterns

Identifiers

PMID40389892
PMCPMC12090507

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.